EAST BANK CLUB
AUTOMATIC BILL PAYMENT
East Bank Club offers Automatic Bill Payment, an easy way for you to pay your bills through your bank account or
with your credit card. To enroll in Automatic Bill Payment, simply fill out the information below and submit it to
Member Services.
East Bank Club will deduct your balance from your bank account or charge your balance to your credit card on
the tenth day of each month. If the tenth day of the month falls on a holiday or weekend, you will be charged on
the next business day.
Please continue to remit your balance due until you receive confirmation from East Bank Club of the date
automatic payments will begin (it may take up to 45 days before the process is complete).
While enrolled in Automatic Bill Payment, we will continue to send you a monthly statement, which will indicate
the amount paid by your financial institution.
You may discontinue Automatic Bill Payment at any time by providing East Bank Club with 30-days-prior written
notice. In addition, if there are any changes to your credit card or bank account, such as an expiration of your
credit card, please provide the Club with 30-days-prior written notice in order to avoid returned payment fees.
Please contact Member Accounts at (312) 527-5800, extension 490, for more information.
AUTOMATIC BILL PAYMENT AUTHORIZATION
Name _______________________________________________________ Membership Number _________________
CREDIT CARD PAYMENT
CHECKING/SAVINGS PAYMENT
(Please submit a blank check marked “void”
with this form.)
o Visa
o American Express
Bank
Name on the Card
_______________________________________
o Checking
o Master Card
o Discover
o Savings
Nine-Digit Bank Routing Number
_______________________________________
Account Number
_______________________________________
_______________________________________
or
Credit Card Number
_______________________________________
Zip Code _____________
Please provide the zip code associated with credit card billing address.
Expiration Date ______ Security Code ______
The Security Code is the three-digit number on the back of the card.
On American Express cards, it is the four-digit number on the front of
the card located next to the card number.
Signature _______________________________________________________________ Date ____________________
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